SimplyAdmin Application Form

If you would like help with filling in your application form, please call us on 0330 1025 337 so we can talk you through the next steps.

Your details

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Office address

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Contact details

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Login details
Your username must be an email address

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Terms of Use

As a user of the Simplyhealth Intermediary On-line service ('the Service') I agree that each time I use the service:

  1. I will use the Service only for lawful purposes and only for the purposes of and in accordance with the Intermediary Terms of Business Agreement and Simplyhealth Legal Notice;
  2. I am an authorised representative of the intermediary linked to this account ('the Intermediary');
  3. I will take all reasonable measures to protect the privacy and security of my password and will not share my password with anyone else;
  4. If I suspect that the security of my password has been compromised I will immediately inform Simplyhealth who will be entitled to change the password with immediate effect;
  5. All information that I provide via the Service is valid, accurate and complete to the best of my knowledge and belief;
  6. Any personal information supplied Simplyhealth as part of this registration/login process and/or any other interaction with simplyhealth.co.uk will be collected, stored and used in accordance with the Simplyhealth Privacy Policy; and
  7. I accept that Simplyhealth has the right exercisable at its sole discretion to withdraw my access to the Service and  to contact the to advise that that my access has been withdrawn.
  8. I accept that my use of the Service is entirely at the discretion of Simplyhealth and is free of charge and that as such Simplyhealth shall have no liability whatsoever in the event that the Service is temporarily disabled and/or withdrawn for whatever reason, including but not limited to remedial work, improvement or refurbishment.